CHILD SURVIVAL UPDATE 15/2008: TWO ON TOBACCO

1) TOBACCO EXPOSURE AND REPRODUCTIVE PARAMETERS

This study in Swedish youth, from the International Journal of Andrology,
confirms evidence from other studies. In brief, high tobacco smoking leads
to reduced sperm counts.

How do these data compare to the virility images of cigarette
advertisements? How many teenage boys are aware of these data? How can
these data be communicated to wannabee smokers?

2) SMOKE EXPOSURE DURING PREGNANCY

In this nine country study, published in the American Journal of Public
Health, Bloch and colleagues review the evidence on exposure to second
hand smoke of pregnant women.

As the tobacco manufacturers shift their marketing focus from developed to
developing countries, this problem is likely to grow in importance in the
developing world.

Good reading.
Cheers, BD

1: Int J Androl. 2008 Feb;31(1):31-9. Epub 2007 Mar 22.

Centre of Reproductive Medicine, Scanian Andrology Centre, Malmö University Hospital, Lund University, Malmö, Sweden. jonas.richthoff@ltkronoberg.se

Cigarette smoking is quite prevalent in the general population but our knowledge of its effect on male reproductive function is still very limited. Therefore, we investigated the impact of tobacco exposure on reproductive characteristics in young males. Military conscripts, 217 non-smokers and 85 smokers, with a median age of 18 years were enrolled. Physical examination and semen analysis, including measurement of accessory sex gland markers and reproductive hormone levels, were performed. Lifestyle-associated factors, including maternal smoking during pregnancy and snuffing, were recorded. Non-smokers had 49% higher total sperm number than smokers (95% CI 4.5-112%, p = 0.01). In addition, sperm concentration was 37% higher among non-smokers (95% CI -4% to 95%, p = 0.08). Serum levels of follicle-stimulating hormone (FSH) were 17% higher among non-smokers (95% CI 3-33%, p = 0.02), whereas no significant differences between smokers and non-smokers were found for inhibin B, testosterone, sex hormone binding globulin, luteinizing hormone and oestradiol. Those who smoked 10 cigarettes per day exhibited 37% lower (95% CI 10-69%, p = 0.005) FSH levels than those who smoked less. Maternal smoking during pregnancy had a negative impact on epididymal and seminal vesicle marker secretion. Smoking seems to impair sperm production and epididymal as well as accessory sex gland function and could be one of the factors contributing to regional differences in sperm parameters.

Objectives. We examined pregnant women's use of cigarettes and other tobacco products and the exposure of pregnant women and their young children to secondhand smoke (SHS) in 9 nations in Latin America, Asia, and Africa. Methods. Face-to-face surveys were administered to 7961 pregnant women (more than700 per site) between October 2004 and September 2005. Results. At all Latin American sites, pregnant women commonly reported that they had ever tried cigarette smoking (range: 78.3% [Uruguay] to 35.0% [Guatemala]). The highest levels of current smoking were found in Uruguay (18.3%), Argentina (10.3%), and Brazil (6.1%). Experimentation with smokeless tobacco occurred in the Democratic Republic of the Congo and India; one third of all respondents in Orissa, India, were current smokeless tobacco users. SHS exposure was common: between 91.6% (Pakistan) and 17.1% (Democratic Republic of the Congo) of pregnant women reported that smoking was permitted in their home. Conclusions. Pregnant women's tobacco use and SHS exposure are current or emerging problems in several low- and middle-income nations, jeopardizing ongoing efforts to improve maternal and child health.

CSU 15/2008: TWO ON TOBACCO